The impact of neighbourhood and school environments on ethnic differences in body size in adolescence

Background: Ethnicity is associated with childhood obesity, with Black African origin girls in particular being more vulnerable to overweight and obesity than their White European peers. In the UK, ethnic minorities often live and attend school in poor urban areas which may influence their opportunity for physical activity and a healthy diet. Aim: To examine neighbourhood and school effects on ethnic differences in Body Mass Index (BMI) and waist circumference trends in adolescence. Methods: Multilevel analysis of longitudinal data on BMI and waist circumference [standard deviation scores (SDS)] from 3401 adolescents in the Determinants of Adolescent Social well-being and Health (DASH) Study (870 White UK, 778 Black Caribbean, 504 Nigerian/Ghanaian, 386 Other African, 418 Indian, and 445 Pakistani/Bangladeshi). Forty-nine London schools participated in the study and the same pupils were surveyed at 11-13yrs and 14-16yrs. Neighbourhood measures included deprivation, crime, and ethnic density; school measures included ethnic density, school socioeconomic status (SES) (academic performance, free school meals, unauthorised absence) and ethos. Individual and family characteristics were also examined (including dietary and physical activity measures, family SES, and parental overweight). Results: Between 11 and 16yrs ethnic differences in BMI emerged in boys and persisted in girls; compared to their White UK peers Black Caribbean and Nigerian/Ghanaian boys and girls, and Other African girls, had a greater mean BMI SDS. These patterns were not observed for waist circumference, signalling ethnic differences in fat distribution or body composition. The DASH pupils overall had large waists compared to the 1990 Growth Reference population. The ethnic minority pupils, with the exception of the Indians, were more likely to live in more deprived, higher crime, less green areas than their White UK peers. However the ethnic minority pupils often attended better performing schools than the White UK pupils. The overall variance in body size at neighbourhood level or school level was small (<4%), and area or school context measures had little or no effect on ethnic differences in body size. Individual characteristics (such as age, pubertal status, and skipping breakfast) and maternal overweight were strong correlates of body size but did not explain the ethnic differences observed. Conclusions: There were significant ethnic differences in BMI in adolescence, emergent in late adolescence for boys. Neighbourhood and school contexts did not explain the ethnic differences in BMI age trends

Trends for coronary heart disease and stroke mortality among migrants in England and Wales, 1979–2003: slow declines notable for some groups

&lt;p&gt;OBJECTIVE: To examine trends in coronary heart disease and stroke mortality in migrants to England and Wales.&lt;/p&gt; &lt;p&gt;DESIGN: Cross-sectional.&lt;/p&gt; &lt;p&gt;OUTCOME MEASURES: Age-standardised and sex-specific death rates and rate ratios 1979-83, 1989-93 and 1999-2003.&lt;/p&gt; &lt;p&gt;RESULTS: Coronary mortality fell among migrants, more so in the second decade than the first. Rate ratios for coronary mortality remained higher for men and women from Scotland, Northern Ireland, Republic of Ireland and South Asia, and lower for men from Jamaica, other Caribbean countries, West Africa, Italy and Spain. Rate ratios increased for men from Jamaica (1979-83: 0.45, 0.40 to 0.50; 1999-2003: 0.81, 0.73 to 0.90), Pakistan (1979-83: 1.14, 1.04 to 1.25; 1999-2003: 1.93, 1.81 to 2.06), Bangladesh (1979-83: 1.36, 1.15 to 1.60; 1999-2003: 2.11, 1.90 to 2.34), Republic of Ireland (1979-1983: 1.18, 1.15 to 1.21; 1999-2003: 1.45, 1.39 to 1.52) and Poland (1979-83: 1.17, 1.09 to 1.25; 1999-2003: 1.97, 1.57 to 2.47), and for women from Jamaica (1979-83: 0.63, 0.52 to 0.77; 1999-2003: 1.23, 1.06 to 1.42) and Pakistan (1979-83: 1.14, 0.88 to 1.47; 1999-2003: 2.45, 2.19 to 2.74), owing to smaller declines in death rates than those born in England and Wales. Rate ratios for stroke mortality remained higher for migrants. As a result of smaller declines, rate ratios increased for men from Pakistan (1979-1983: 0.99, 0.76 to 1.29; 1999-2003: 1.58, 1.35 to 1.85), Scotland (1979-1983: 1.11, 1.04 to 1.19; 1999-2003: 1.30, 1.19 to 1.42) and Republic of Ireland (1979-1983: 1.27, 1.19 to 1.36; 1999-2003: 1.67, 1.52 to 1.84).&lt;/p&gt; &lt;p&gt;CONCLUSION: For groups with higher mortality than people born in England and Wales, mortality remained higher. Smaller declines led to increasing disparities for some groups and to excess coronary mortality for women from Jamaica. Maximising the coverage of prevention and treatment programmes is critical.&lt;/p&gt

Child allergic symptoms and well-being at school:Findings from ALSPAC, a UK cohort study

Eczema and asthma are common conditions in childhood that can influence children's mental health. Despite this, little is known about how these conditions affect the well-being of children in school. This study examines whether symptoms of eczema or asthma are associated with poorer social and mental well-being in school as reported by children and their teachers at age 8 years.Participants were from the Avon Longitudinal Study of Parents and Children. Measures of child well-being in school were child-reported (n = 6626) and teacher reported (n = 4366): children reported on their enjoyment of school and relationships with peers via a self-complete questionnaire; teachers reported child mental well-being using the Strengths and Difficulties Questionnaire [binary outcomes were high 'internalizing' (anxious/depressive) and 'externalizing' (oppositional/hyperactive) problems (high was >90th percentile)]. Child rash and wheeze status were maternally reported and symptoms categorised as: 'none'; 'early onset transient' (infancy/preschool only); 'persistent' (infancy/preschool and at school age); and 'late onset' (school age only).Children with persistent (OR 1.29, 95% CI 1.02 to 1.63) and late onset (OR 1.48, 95% CI 1.02 to 2.14) rash were more likely to report being bullied, and children with persistent wheeze to feel left out (OR 1.42, 95% CI 1.10 to 1.84). Late onset rash was associated with high teacher-reported internalising behaviours (OR 1.61, 95% CI 1.02 to 2.54), and persistent rash with high externalising behaviours (OR 1.37, 95% CI 1.02 to 1.84). Child sleep and maternal mental health explained some of the associations with teacher-reported mental well-being.Symptoms of eczema or asthma can adversely affect a child's social and mental well-being at primary school. This suggests interventions, such as additional support or education of peers, should begin at early stages in schooling

Changes in marital quality over 6 years and its association with cardiovascular disease risk factors in men: findings from the ALSPAC prospective cohort study

Background: Marital relationship quality has been suggested to have independent effects on cardiovascular health outcomes. This study investigates the association between changes in marital relationship quality and cardiovascular disease (CVD) risk factors in men. Methods: We used data from The Avon Longitudinal Study of Parents and Children, a prospective birth cohort study (Bristol, UK). Our baseline sample was restricted to married study fathers with baseline relationship and covariate data (n=2496). We restricted final analysis (n=620) to those with complete outcome, exposure and covariate data, who were married and confirmed the study child’s father at 6.4 years and 18.8 years after baseline. Relationship quality was measured at baseline and 6.4 years and operationalised as consistently good, improving, deteriorating or consistently poor relationship. We measured CVD risk factors of blood pressure, resting heart rate, body mass index, lipid profile and fasting glucose at 18.8 years after baseline. Results: Improving relationships were associated with lower levels of low-density lipoprotein (−0.25 mmol/L, 95% CI −0.46 to −0.03) and relative reduction of body mass index (−1.07 kg/m2, 95% CI −1.73 to −0.42) compared with consistently good relationships, adjusting for confounders. Weaker associations were found between improving relationships and total cholesterol (−0.24 mmol/L, 95% CI −0.48 to 0.00) and diastolic blood pressure (−2.24 mm Hg, 95% CI −4.59 to +0.11). Deteriorating relationships were associated with worsening diastolic blood pressure (+2.74 mm Hg, 95% CI 0.50 to 4.98). Conclusions: Improvement and deterioration of longitudinal relationship quality appears associated with respectively positive and negative associations with a range of CVD risk factors

Response to: 'On the approach for determining association between changes in marital quality and cardiovascular disease risk factors' by MM Pike

No abstract available

Sex differences in child and adolescent physical morbidity: cohort study

Background Evidence on sex differences in physical morbidity in childhood and adolescence is based largely on studies employing single/few physical morbidity measures and different informants. We describe sex differences in a wide range of parent/carer-reported physical morbidity measures between ages 4 and 13 years to determine evidence for a generalised pattern of an emerging/increasing female ‘excess’. Methods Parents/carers (approximately 90% mothers) of the population-based UK ALSPAC cohort provided data on general health, physical conditions/symptoms and infections in their child approximately annually between ages 4 and 13. Logistic regression analyses determined the odds of each morbidity measure being reported in respect of females (vs males) at each age and the sex-by-age interaction, to investigate any changing sex difference with age. Results Six measures (general health past year/month, high temperature, rash, eye and ear infections) demonstrated an emerging female ‘excess’, and six (earache, stomach-ache, headache, lice/scabies, cold sores, urinary infections) an increasing female ‘excess’; one (breathlessness) showed a disappearing male ‘excess’. Just two showed either an emerging or increasing male ‘excess’. Most changes were evident during childhood (prepuberty). Six measures showed consistent female ‘excesses’ and four consistent male ‘excesses’. Few measures showed no sex differences throughout this period of childhood/early adolescence. Conclusion Sex differences are evident for a wide range of parent-reported physical morbidity measures in childhood and early adolescence. Far more measures showed an emerging/increasing female ‘excess’ than an emerging/increasing male ‘excess’. Further studies are required to examine whether patterns differ across sociodemographic/cultural groups, and to explain this generalised pattern

Cohort profile: the DASH (determinants of adolescent social well-being and health) study, an ethnically diverse cohort

No abstract available

The potential for linking cohort participants to official criminal records: a pilot study using the Avon Longitudinal Study of Parents and Children (ALSPAC)

Introduction: Linking longitudinal cohort resources with police-recorded records of criminal activity has the potential to inform public health style approaches to policing, and may reduce potential sources of bias from self-reported criminal data collected by cohort studies. A pilot linkage of police records to the Avon Longitudinal Study of Parents and Children (ALSPAC) allows us to consider the acceptability of this linkage, its utility as a data resource, differences in self-reported crime according to consent status for data linkage, and the appropriate governance mechanism to support such a linkage.Methods: We carried out a pilot study linking data from the ALSPAC birth cohort to Ministry of Justice (MoJ) records on criminal cautions and convictions. This pilot was conducted on a fully anonymous basis, meaning we cannot link the identified records to any participant or the wider information within the dataset. Using ALSPAC data, we used summary statistics to investigate differences in socio-economic background and self-reported criminal activity by consent status for crime linkage. We used MoJ records to identify the geographic and temporal concentration of criminality in the ALSPAC cohort.Results: We found that the linkage appears acceptable to participants (4% of the sample opted out), levels of criminal caution and conviction are high enough to support research, and that the majority of crimes occurred in Avon & Somerset (the policing area local to ALSPAC). Those who did not respond to consent requests had higher levels of self-reported criminal behaviour compared to participants who provided explicit consent.Conclusions: These findings suggest that data linkage in ALSPAC provides opportunities to study criminal behaviour and that linked individual-level records could provide robust research in the area. Our findings also suggest the potential for bias when only including participants who have explicitly consented to data linkage, highlighting the limitations of opt-in consent strategies

The impact of cycle proficiency training on cycle-related behaviours and accidents in adolescence:Findings from ALSPAC, a UK longitudinal cohort

Abstract Background Cycle accidents are a common cause of physical injury in children and adolescents. Education is one strategy to reduce cycle-related injuries. In the UK, some children undertake National Cycle Proficiency Scheme [NCPS] training (now known as Bikeability) in their final years of primary school. It aims to promote cycling and safe cycling behaviours but there has been little scientific evaluation of its effectiveness. Methods The sample (n = 5415) were participants in the Avon Longitudinal Study of Parents and Children who reported whether or not they had received NCPS training. Outcomes were self-reported at 14 and 16 years: cycling to school, ownership of cycle helmet, use of cycle helmet and high-visibility clothing on last cycle, and involvement in a cycle accident. An additional outcome, hospital admittance due to a cycle accident from 11 to 16 years, was also included for a subsample (n = 2222) who have been linked to Hospital Episode Statistics (HES) data. Results Approximately 40 % of the sample had received NCPS training. Trained children were more likely to cycle to school and to own a cycle helmet at both 14 and 16 years, to have worn a helmet on their last cycle at age 14, and to have worn high-visibility clothing at age 16, than those who had not attended a course. NCPS training was not associated with self-reported involvement in a cycle accident, and only six of those with HES data had been admitted to hospital due to a cycle accident. Irrespective of training, results indicate very low use of high-visibility clothing, very few girls cycling as part of their school commute, and less than half of helmet owners wearing one on their last cycle. Conclusions Our results suggest cycle training courses for children can have benefits that persist into adolescence. However, the low use of cycle helmets, very low use of high-visibility clothing, and low levels of cycling to school for girls, indicate the further potential for interventions to encourage cycling, and safe cycling behaviours, in young people